Search Decisions

Decision Text

AF | PDBR | CY2012 | PD 2012 01935
Original file (PD 2012 01935.rtf) Auto-classification: Approved
RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXXXXXXX     CASE : PD -20 12 - 01935
BRANCH OF SERVICE: Army   BOARD DATE: 201 4 0626
Separation Date: 20030530


SUMMARY OF CASE : Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty SPC/E-4 (14T10/Patriot Enhancement Operator and Maintainer) medically separated for chronic left knee pain. The condition could not be adequately rehabilitated to meet the physical requirements of his Military Occupational Specialty (MOS) or satisfy physical fitness standards. He was issued a permanent L3 profile and referred for a Medical Evaluation Board (MEB). The chronic left knee pain condition was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501. No other conditions were submitted by the MEB. The Informal PEB adjudicated chronic left knee pain following partial lateral meniscus tear status post (s/p) diagnostic arthroscopy as unfitting, rated 0%. The CI made no appeals and was medically separated.

invalid font number 31502
CI CONTENTION : “ I have seen my doctor at least 25 times for my service-connected disability. None of my conditions seem to be getting better worst on most cases.”


SCOPE OF REVIEW : The Board’s scope of review is defined in DoDI 6040.44, Enclosure 3, paragraph 5.e . ( 2). It is limited to those conditions determined by the PEB to be unfitting for continued military service and those conditions identified but not determined to be unfitting by the PEB when specifically requested by the CI. The rating for the unfitting chronic left knee pai n condition is addressed below; no additional conditions are within the DoDI 6040.44 defined purview of the Board. Any conditions or contention not requested in this application, or otherwise outside the Board’s defined scope of review, remain eligible for future consideration by the Board for Correction of Military Records.


invalid font number 31502 RATING COMPARISON invalid font number 31502 :
 invalid font number 31502
Service IPEB – Dated 20030318
 VA - Exam ~ 1.5 Mos Pre-Separation
Condition
 Code Rating Condition Code Rating Exam
Chronic Left Knee Pain… 5099-5003 0% Chondromalacia Patellae, s/p Meniscectomy, Left Knee 5260-5014 10%* 20030415
No Additional MEB/PEB Entries
 Other x6
Combined: 0%
 Combined: 40%
* As reflected in VA Rating Decision (VARD) dated 20130430 . Original VARD not in evidence.


ANALYSIS SUMMARY : The Board acknowledges the impairment with which his service-connected condition continues to burden him but notes the Disability Evaluation System has neither the role nor the authority to compensate members for anticipated future severity or potential complications of conditions resulting in medical separation. That role and authority is granted by Congress to the Department of Veterans Affairs, operating under a different set of laws .


Chronic Left Knee Pain Condition . There were two goniometric range - of - motion (ROM) evaluations in evidence, with documentation of additional ratable criteria, which the Board weighed in arriving at its rating recommendation , as summarized in the chart below.

Left Knee ROM(Degrees) MEB 5.5 Mo. Pre-Sep VA C&P 1.5 Mo. Pre-Sep
Flexion (140 Normal) 130 140
Extension (0 Normal) 0 0
Comment “ daily pain with activities”; Pos. t enderness to palpation (TTP) ; Neg. instability; Normal strength Pos. tenderness to ballottement (compress patella, release quickly) ; No instability; Pos. cr ep itus ; “daily pain with activities”
§4.71a Rating 10% 10 %
invalid font number 31502
The CI sustained a twisting injury to his left knee in February 2001 and had an immediate onset of left lateral knee pain and significant loss of motion . He developed multiple episodes of left knee locking and popping associated with pain and intermittent effusions. The CI underwent a diagnostic arthroscopy for a left knee lateral meniscus tear in April 2001 . Despite a course of physical therapy (PT ) the left knee continued to demonstrate tenderness to palpation ( TTP ) laterally with constant pain that was occasionally sharp. A left knee X -ray ordered in October 2001 , because of recurrent , pain was normal . In January 2002, a PT note documented exam findings of medial knee pain with very TTP over the left medial collateral ligament at the joint line and positive for tight hamstring muscles on straight leg raise to 60 degrees. The o rthopedis t in June 2002 noted that the CI had chronic left knee pain which interfered with his duties and ROM was limited to 135 degrees flexion. T he CI was given a permanent L3 p rofile for left knee pain with additional restrictions of no running, jumping or climbing. The MEB narrative summary ( NARSUM ) exam dated 16 December 2002 , approximately 5.5 months prior to separation , documented that the CI failed all conservative treatments since the arthroscopy and continued to have left knee swelling at night, difficulty with ambulation , running, and performing deep knee bends and a limited ROM. The CI reported that the continued left knee pain ranged from sharp to dull depending on his activity. The MEB NARSUM physical exam findings are summarized in the chart above. The c ommander’s s tatement dated 11 March 2003 noted that he CI was very limited in performing duties with in his MOS. A repeat left knee X -ray in April 2003 was normal. T he VA Compensation and Pension exam approximately 1.5 half months prior to separation documented that the CI continued to have daily left knee pain approximately seven of ten , worse with running, walking and climbing stairs.

The Board directs attenti on to its rating recommendation based on the above evidence . The PEB coded the chronic left knee pain condition as 5099 analogous to 5003 a rthritis, degenerative (hypertrophic or osteoarthritis) and rated i t 0% citing “There is no joint instability or loss of range - of - motion.” The VA applied th e analogous code of 5260-5014, o steomalacia (which refers to code 5003 for rating) and rated the knee at 10%. There is ample evidence of pain with activities in the service treatment record. All exams proximate to separation documented painful motion. No exam documented limited ROM to a compensable degree absent application of §4.59 (painful motion). VASRD §4.71 specifies for 5003 that “satisfactory evidence of painful motion” constitutes limitation of motion and specifies application of a 10% rating for each such major joint or group of minor joints affected by limitation of motion. ” The Board considered alternate codes such as 5259 ( sy mptomatic removal of semilunar c artilage ) , however , no other rating code would achieve a rating higher than 10%. After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board recommends a disability rating of 10 % for the c hronic l eft k nee p ain condition.

invalid font number 31502
BOARD FINDINGS : IAW DoDI 6040.44, provisions of DoD or Military Department regulations or guidelines relied upon by the PEB will not be considered by the Board to the extent they were inconsistent with the VASRD in effect at the time of the adjudication. The Board did not surmise from the record or PEB ruling in this case that any prerogatives outside the VASRD were exercised. In the matter of the chronic left knee pain condition, the Board unanimously recommends a disability rating of 10 %, coded 5099-5003 IAW VASRD §4.71a. There were no other conditions within the Board’s scope of review for consideration.

invalid font number 31502
invalid font number 31502 RECOMMENDATION invalid font number 31502 : invalid font number 31502 invalid font number 31502 The Board recommends that the CI’s prior determination be modified as follows, effective as of the date of his prior medical invalid font number 31502 separation: invalid font number 31502

UNFITTING CONDITION VASRD CODE RATING
Chronic Left Knee Pain 5099-5003 1 0%
COMBINED 1 0%
invalid font number 31502

The following documentary evidence was considered:
Exhibit A. DD Form 294, dated 20 121128 , w/atchs
Exhib it B. Service Treatment Record
Exhibit C. Department of Veterans ’ Affairs Treatment Record








                          
XXXXXXXXXXXXXXX
President
Physical Disability Board of Review
invalid font number 31502




SAMR-RB                                                                         


MEMORANDUM FOR Commander, US Army Physical Disability Agency
(AHRC-DO), 2900 Crystal Drive, Suite 300, Arlington, VA 22202-3557


 SUBJECT: Department of Defense Physical Disability Board of Review Recommendation
for XXXXXXXXXXXXXXX, AR20140020828 (PD201201935)
1. I have reviewed the enclosed Department of Defense Physical Disability Board of Review (DoD PDBR) recommendation and record of proceedings pertaining to the subject individual. Under the authority of Title 10, United States Code, section 1554a, I accept the Board’s recommendation to modify the individual’s disability rating to 10% without recharacterization of the individual’s separation. This decision is final.

2. I direct that all the Department of the Army records of the individual concerned be corrected accordingly no later than 120 days from the date of this memorandum.

3. I request that a copy of the corrections and any related correspondence be provided to the individual concerned, counsel (if any), any Members of Congress who have shown interest, and to the Army Review Boards Agency with a copy of this memorandum without enclosures.

BY ORDER OF THE SECRETARY OF THE ARMY:

Encl                                                  XXXXXXXXXXXXXXX
                                                      Deputy Assistant Secretary
                                                      (Army Review Boards)

CF:
( ) DoD PDBR
( ) DVA

Similar Decisions

  • AF | PDBR | CY2014 | PD-2014-00517

    Original file (PD-2014-00517.rtf) Auto-classification: Approved

    invalid font number 31502 IPEB – Dated 20060915VA* - (~4 days Pre-Separation) ConditionCodeRatingConditionCodeRatingExam Chronic Left Ankle Pain…5099-50030%S/P Left Ankle Arthroscopy Debridement…5271-501010%20061012Scar, S/P Left Ankle Arthroscopy Debridement…780410%20061012Other MEB/PEB Conditions x 0 (Not In Scope)Other x 8 RATING: 0%COMBINED RATING: 50% *Derived from VA Rating Decision (VARD) dated 20061108 (most proximate to date of separation (DOS)). Left Ankle Condition . The VA...

  • AF | PDBR | CY2013 | PD-2013-02688

    Original file (PD-2013-02688.rtf) Auto-classification: Approved

    The Informal PEB (IPEB)adjudicated the chronic bilateral knee pain as unfitting, rated 10%, citing application of the Veterans Affairs Schedule for Rating Disabilities (VASRD). The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of the VASRD standards to the unfitting medical condition at the time of separation. invalid font number 31502 BOARD FINDINGS : IAW DoDI 6040.44, provisions of DoD or Military...

  • AF | PDBR | CY2014 | PD-2014-00232

    Original file (PD-2014-00232.rtf) Auto-classification: Approved

    The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical condition at the time of separation. Post-Separation)ConditionCodeRatingConditionCodeRatingExam Left Knee Pain PFPS5099-50030%Incomplete Tear, Left ACL, Left Knee5299-52620%20080328Other x0Other x3(Not in Scope) Combined: 0%Combined: 10%*Derived from VA...

  • AF | PDBR | CY2014 | PD-2014-01877

    Original file (PD-2014-01877.rtf) Auto-classification: Approved

    The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical condition at the time of separation. Bilateral Knee Pain Condition . In the matter of the bilateral knee pain condition, the Board unanimously recommends that each joint be separately adjudicated as follows: an unfitting right knee pain condition coded...

  • AF | PDBR | CY2014 | PD-2014-00182

    Original file (PD-2014-00182.rtf) Auto-classification: Approved

    The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical condition at the time of separation. The VA’s decision was based on the fact that the CI had no medical treatment and therewas no diagnosed neck condition while on active duty or that this condition was due to active duty service.The Board’s main charge...

  • AF | PDBR | CY2013 | PD-2013-01533

    Original file (PD-2013-01533.rtf) Auto-classification: Approved

    The Informal PEB adjudicated “TBI with residual neck pain and headaches;” “low back pain (LBP);” and “left knee pain with degenerative joint disease (DJD),” as unfitting, rated at 10%, 10%, and 0% respectively, with application of the Veterans Affairs Schedule for Rating Disabilities (VASRD). The Board could not find evidence in the commander’s statement or elsewhere in the treatment record that documented any significant interference of the neck pain condition with the performance of...

  • AF | PDBR | CY2013 | PD 2013 00518

    Original file (PD 2013 00518.rtf) Auto-classification: Denied

    The CI had a long history of chronic right knee pain and arthritis dating from 1992. The PEB coded the DDD right knee condition as 5003 arthritis, degenerative (hypertrophic or osteoarthritis) and rated at 10%.The VA coded the right knee s/posteotomy proximal tibial plateau, with DJD condition and rated at 5010 arthritis, due to trauma, substantiated by X-ray findings with 5262tibia and fibula, impairment of and rated at 20%, with moderate knee disability, citing, “ This 20percent is...

  • AF | PDBR | CY2013 | PD2013 01246

    Original file (PD2013 01246.rtf) Auto-classification: Approved

    The PEB adjudicated “right, dominant, shoulder pain… ,” “right hip pain,” and “bilateral heel pain and right ankle pain” as unfitting, rated 10%, 0% and 0% (respectively), citing criteria of the VA Schedule for Rating Disabilities (VASRD). Post-Separation)ConditionCodeRatingConditionCodeRatingExam Right Shoulder Pain…5099-500310%Right Shoulder Arthritis5010-520110%20091125Right Hip Pain…5099-50030%Right Hip Bursitis5024-525210%Bilateral Heel Pain and Right Ankle Pain…52840%Stress Fracture,...

  • AF | PDBR | CY2014 | PD 2014 00376

    Original file (PD 2014 00376.rtf) Auto-classification: Denied

    The rating for the unfitting right knee is addressed below; no additional conditions (the contended left knee, arthritis, nerve damage, GERD and hiatal hernia) are not within the DoDI 6040.44 defined purview of the Board. The examiner opined that theCI’s history of prior knee surgery was most likely exacerbated by the fall.The MEB NARSUM physical exam findings are summarized in the chart below.The VA Compensation and Pension (C&P) exam performed on 3 August 2005,10 months after separation,...

  • AF | PDBR | CY2013 | PD-2013-02437

    Original file (PD-2013-02437.rtf) Auto-classification: Denied

    The CI was given a U3/L3 profile for LBP and right wrist pain. The PT noted that althoughhis right wrist was showing improvement, the CI had wrist pain with pushups.The MEB NARSUM exam documented that the CI was unable to perform basic soldering duties or carry/lift more than 25 pounds or engage in repetitive gripping, bending or twisting of the right wrist.The MEB NARSUM physical exam findings are summarized in the chart below. The VA coded the arthropathy of right wrist condition as 5003...